A case of pulmonary embolism occured after injection of bovine collagen / 대한내과학회지

Collagen and its products, used in some medical field are relatively safe but may induce hypersensitivity reaction. However, pulmonary embolism is a rare but serious complication after injection of them. A-48-year old woman was admitted because of cough, hemoptysis and dyspnea. Nine days ago, she had received breast augmentation with injectable collagen by unlicensed person. Four days later, she experienced cough, hemoptysis and dyspnea. On admission right side pleural effusion and peripheral distributed diffuse consolidations in both lungs were noted on chest radiograph. A computed tomographic (CT) scan of the chest showed non-segmental distribution of bilateral ground-glass opacity and interlobular septal thickening with multifocal consolidation in both lungs. Sputum and urine cytologic examination revealed foamy histiocytes containing lipid vaculoes. Conservative management was done under the impression of pulmonary embolism after collagen injection. She was dischared with full recovery. Here, we report a case of pulmonary embolism occurred after infection of collagen first in Korea.

Primary Sjogren's Syndrome Associated with Membranous Glomerulonephritis / 대한신장학회잡지

Sjogren's syndrome is a chronic autoimmune disorder causing dry eye or dry mouth from the lymphocytic infiltration in the lacrimal gland and the salivary gland. Renal involvement is seen in about 20-40% of patients with primary Sjogren's syndrome. Tubulointerstitial nephritis is the most common renal complication in primary Sjogren's syndrome. However, glomerulonephritis such as membranoproliferative glomerulonephritis, membranous glomerulonephritis rarely may complicate primary Sjogren's syndrome. Sjogren's syndrome associated with glomerulonephritis hasn't been reproted yet in Korea. We report nephrotic syndrome associated with membranous glomerulonephritis in a case with primary Sjogren's syndrome. Nephrotic syndrome resolved after treatment with corticosteroid.

Usefulness of Urinary Trypsinogen-2 Dipstick Test for Diagnosis of Acute Pancreatitis / 대한소화기학회지

BACKGROUND/AIMS: The clinical usefulness of urinary trypsinogen-2 dipstick test is still in controversy. We evaluated the usefulness of urinary trypsinogen-2 dipstick test in patients with acute pancreatitis. METHODS: Urinary trypsinogen-2 dipstick test was prospectively performed in 50 patients with acute pancreatitis, 50 patients with non-pancreatic abdominal pain, and 50 healthy controls. RESULTS: On admission, urinary trypsinogen-2 dipstick test was positive in 36 of 50 patients with acute pancreatitis (sensitivity, 72%) and in 4 of 50 patients with non-pancreatic abdominal pain (specificity, 92%). On the other hand, it was all negative in controls. The sensitivity and specificity of serum lipase were 78% and 94%, respectively. At 24 hours after admission, the positive rate of urinary trypsinogen-2 dipstick test rose from 72% to 94% (p=0.02). The results of urinary trypsinogen-2 dipstick test was positive in 14 of 15 patients with severe pancreatitis and 22 of 35 patients with mild pancreatitis according to the criteria by Atlanta International Symposium, 1992. CONCLUSIONS: Urinary trypsinogen-2 dipstick test is comparable to serum lipase in diagnosing acute pancreatitis. Delayed measurement and severe pancreatitis are more likely to yield positive results with urinary trypsinogen-2 dipstick test. Thus, we suggest that the cut-off value of urinary trypsinogen-2 dipstick test should be lowered to increase its sensitivity.